Proof of Delivery
STRAIGHT BILL OF LADING – SHORT FORM – ORIGINAL – NOT NEGOTIABLE
This form contains only the information necessary for the motor carrier to deliver, rate, and invoice the
shipment described below.
Shipper: Ship Date 01/25/2020
Wally’s Weld Works
111 Welder Way Carrier Trucking Inc
Lenexa, KS 66219 Load# 1122334455
Wally (888) 555-8888 BOL# 00141411234567890
Consignee: Due Date 01/30/2020
Cal’s Covers All Freight charges PPD/3rd party bill to:
222 Twin St. Billing
Irving, TX 75063 123 Main St.
Al (222) 333-1111 Laguna Beach, CA 92677
Reference Number: PO’s 9761902
Shipper Special Instructions:
Consignee Special Instructions:
Shipper Signature: ______________________ Date: _____________ Trailer# _______________
Consignee Signature: ___________________ Date: _____________ Seal#_________________
Driver Signature: ________________________ Date: _____________ Seal# ________________
Thank you for your business!
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